Susan Slater MD MPH Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A126920 Issued in CA

Legal business name

SUSAN SLATER MD MPH INC

Practice address

2715 E Main St
Ventura, CA 93003-2803

Phone

(805) 804-7589

Fax

(866) 280-2649

NPI assigned

Feb 10, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Susan Slater, MD, MPH

Title

President

Phone

(805) 316-1177

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1245739770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 HARBOR BLVD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013904",
            "telephone_number": "310-701-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 E MAIN ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032803",
            "telephone_number": "805-804-7589",
            "fax_number": "866-280-2649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Carmen Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930103103",
            "country_code": "US",
            "telephone_number": "805-316-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUSAN SLATER MD MPH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-10",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "SLATER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-316-1177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A126920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.